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Eczema Facts

Eczema Medication Series – Cyclosporine

Cyclosporine EczemaThis is a series on some of the medication that I’ve collated from parents who shared in forums. My baby with eczema hadn’t been prescribed these, but my usual investigative self got interested after reading mixed feedback on these medicines. Do share in the comments your child’s experience, and the effect on his/her eczema.

What is Cyclosporine?

Cyclosporine is an immunosuppressant, and slows down the immune system (thus frequently prescribe to prevent organ rejection after a transplant). It is registered in certain countries to treat skin conditions – psoriasis and atopic dermatitis (eczema). It may be prescribed for those with severe eczema that has not responded to other treatments for prolonged period. Cyclosporine works by reducing inflammation on the skin, through its effect on immune cells (lymphocytes). It is taken orally, and patient needs to follow the prescription carefully and take the medication at same time. The dosage prescribed will be determined by the doctor, usually for skin-related, it will be a low dosage, and dosage may vary during the course. It is important to follow-through with the prescription, and not terminate it once you self-assessed your condition has improved.

Monitoring

Certain tests may be requested by your doctor, to assess the side effects of cyclosporine, such as blood pressure test, blood and urine tests (to monitor creatinine levels) and tests to monitor potassium, blood count, fasting lipid, uric acid and liver function.

Warning

Care ought to be taken to ensure that the prescription of Cyclosporine is the right one, as it can be in different form – original vs modified. Different form of cyclosporine is to be mixed with different liquids, so do check with your doctor too. Also check with your doctor on what other medication to avoid, especially those that affect the immune system, such as azathioprine, methotrexate and tacrolimus. There is associated risk with high blood pressure, kidney damage, lymph and skin cancer, so do check with the doctor if your child should take additional sun protection measures, and for adults, avoid phototherapy during the medication. Do not drive as side effect of cyclosporine is dizziness. Avoid contact with people who are ill, and also those who have taken a recent nasal flu vaccine (also check with the doctor before you/ your child get vaccinated).

Side Effects

Watch for side effects, and let your doctor know; some of the side effects are:

Headache, vomiting, diarrhea, nausea, increased hair growth on face or body,  swollen gums, acne, trembling, flushing, cramps, joint pains, pin and needle sensation, flu, sore throat, facial pain and increased blood pressure .

The serious side effects to call your doctor immediately are bleeding, bruising, paleness, yellowing of skin or eyes, seizures, fainting, difficulty with body movements, swelling and vision changes, painful urination.

Refer here which side effects are more common, and which are less.

Diet

Grapefruit and juice is to be avoided as it can increase the amount of cyclosporine in your blood stream. Foods such as bananas, prunes that are high in potassium are to be limited as cyclosporine can also increase the amount of potassium in the bloodstream. Check also if you need to take magnesium supplement, as cyclosporine may reduce the level of magnesium in the blood.

Most Importantly, Does it Work?

I’ve found a few studies online, and the various conclusions are:

  1. Studied to offer relief for those with severe eczema, but the effect is not long-lasting, similar conclusion in this study.
  2. Review article of 15 studies found cyclosporine to be effective for 6-8 weeks.
  3. One study that tracked up to 1 year continued to show eczema in remission, but this study was without control group.
  4. In a study involving 40 children, cyclosporine found to be effective and well-tolerated. In this study involving 35 children, cyclosporine found to be more effective for those whose eczema are triggered by skin infection (than those triggered by others)

A point to note is above studies were small sample sizes, possibly due to cyclosporine prescribed only for severe instances. Do share your experience in the comments!

9 replies on “Eczema Medication Series – Cyclosporine”

Hi I was wondering does anyone know how long the nausea will last for while on cyclosporine. I’m getting each time I take them

Hi was great to read this it sounded positive until I saw Gary’s post which sounds scary 🙁 I’ve had eczema since I was born it was really bad as a kid I had to be wet bandages etc but I grew up n it seemed to be manageable most of my friends n partners over the years never even knew I had exxema I’m now 20 n just had a son n my eczema has come back soooo severely!! I’ve tried everything I’m now on a course of light treatments it’s my third week but I’m still in so much pain n itchy my skin cracks so bad I can’t even play with my son whose now 1 n it kills me please if you could keep me updated on treatments I’m willing to try anything that will help. Shan xx

Hi Shanequar,

Sorry to hear of worsening eczema after pregnancy.. does breastfeeding limits the medication that you can take? If you’re taking any, do check with your doc…

Take care,
Mei

Yes, I’m researching more on eczema meds, and realized that there are even stronger meds than cyclosporine, used when kids didn’t respond to cycolosporine and conventional med, or due to its side effects. It’s very saddening, as it impacts immune system at the time when the little bodies of the children are trying to build it up..
I never heard of these meds, till I kept reading them in forums..

I took Cyclosporine for about 2 years in my mid-30’s. I developed a pre-cancerous mass of cells from the drug. After 2 months of biopsies and analysis, I was diagnosed with “ebv associated lymphoproliferative disorder consistent with b cell lymphoma.”

The “cure” was to stop the drug and the cells went away. A bitter sweet ending, since I was out of danger, but my eczema came back in full force.

I ended up on Cellcept 2 years later which has been effective and safe for the past 5-6 years.

Hope this helps. Gary

Thanks Gary, I appreciate your sharing! I’ve also come across people mentioning Cellcept, and was going to write about this. Good to hear it worked for you, always happy to hear of someone with eczema finding a way to manage it. Don’t neglect the basic moisturizing 🙂
Take care!
Mei

Your sharing will help others!